Evidence map›Paper›PMID 32671589›Full record

ReviewDigestive diseases and sciences2020

Medical, Political, and Economic Considerations for the Use of MAC for Endoscopic Sedation: Big Price, Little Justification?

Basavana Goudra, Preet Mohinder Singh, Gary R Lichtenstein

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Digestive diseases and sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Review
  7. A comprehensive review of remimazolam for sedation.Health psychology research · 2021
    Review
  8. Review
  9. Oliceridine- Opioid of the 21Saudi journal of anaesthesia
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Basavana GoudraPerelman School of Medicine, Hospital of the University of Pennsylvania, 680 Dulles, 3400 Spruce Street, Philadelphia, PA, 19104, USA. goudrab@uphs.upenn.edu.ORCID http://orcid.org/0000-0002-5146-0424
Preet Mohinder SinghDepartment of Anesthesiology, Washington University in Saint Louis, 660 South Euclid Avenue, St Louis, MO, 63110, USA.ORCID http://orcid.org/0000-0001-7642-529X
Gary R LichtensteinDivision of Gastroenterology, Department of Medicine, Center for Inflammatory Bowel Disease, Raymond and Ruth Perelman School of Medicine of the University of Pennsylvania, GI Administration Offices, 7th Floor South Pavilion, Room 753, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA, 19104-4283, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The last few decades of gastrointestinal (GI) endoscopy have seen phenomenal growth. In many aspects, GI endoscopy has led the field of nonsurgical interventional medicine. In many aspects, this growth is facilitated by advancements in sedation-both drugs and techniques. Unfortunately, the topic of GI endoscopy sedation is also mired in many controversies, mainly emanating from the cost of anesthesia providers. While no one debates their role in the majority of advanced endoscopic procedures, the practice of universal propofol sedation in the USA, delivered by anesthesia providers, needs a closer look. In this review, medical, political, and economic considerations of this important topic are discussed in a very frank and honest way. While such ubiquitous propofol use has increased satisfaction of both patients and gastroenterologists, there is little justification. More importantly, going by the evidence, there is even less justification for the mandated anesthesia providers use for such delivery. Unfortunately, the FDA could not be convinced otherwise. The new drug fospropofol met the same fate. Approval of SEDASYS

Indexed as

Delivery of Health CareEndoscopy, GastrointestinalPolicy MakingAnesthetics, IntravenousBenzodiazepinesCost-Benefit AnalysisDrug ApprovalDrug CostsHumansHypnotics and SedativesPatient SafetyPropofolSpiro CompoundsThiophenesUnited StatesUnited States Food and Drug Administration((3-methoxythiophen-2-yl)methyl)((2-(9-(pyridin-2-yl)-6-oxaspiro(4.5)decan-9-yl)ethyl))amineAnesthetics, IntravenousBenzodiazepinesHypnotics and SedativesPropofolremimazolamSpiro CompoundsThiophenesGI endoscopyOliceridinePropofolRemimazolamSedasysSedation

Identifiers

PMID32671589
PMCPMC7363687

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.